Edward Kelly Furlong, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D010727 Issued in AZ

Practice address

5400 W Northern Ave Ste 202
Glendale, AZ 85301-1591

Phone

(623) 500-5793

NPI assigned

Jun 18, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Blue Sky Dentistry

  • Dental Clinic/Center
  • Phoenix, AZ
  • NPI 1346975018
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1592438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1558987271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12226 N 56TH DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041821",
            "telephone_number": "406-570-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 W NORTHERN AVE STE 202",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853011591",
            "telephone_number": "623-500-5793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FURLONG",
        "first_name": "EDWARD",
        "middle_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-18",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D010727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hayden Reese Fuller
• Christopher Leigh Fullmer
• Samaiyah Fullylove
• Mary Beth Funnell, RN
• Catherine G Furey, OD
• Deanna Fussy, FNP
• Kristen Fyfe
• G2 Physicians LLC
• Steven M Gabaldon, P.A.-C
• Jordan Gabbard

• General Practice Dentistry in Glendale, AZ
• Providers in Glendale, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.